Mets to lungs and lymph nodes need some advice

[Niso]

Hi there, i was diagnosed with oligometastatic pca 6 years ago,51 yo psa was 25, tried to go on a curative path and went for prostatectomy followed with radiotherapy +sbrt to ilium bone suspicion for bone met and pelvic lymph nodes +adt and abiraterone for 24 months.I have refused to chemo along the way and prefer to save it to further stages of my journey.

Stopped treatment after 2 years as planned, after few months testosterone went up and sadly so did the psa,pet psma showed involvement of supracalvicular lymph node went back on orgovyx+ abirateron, psa dropped to 0.01 .

After few months psa started rising very slowly and now after 18 months psa is 0.37, i know its pretty low but it looks like doubling time is 110 days. went through another pet psma scan and now 3-4 lesions in lymph nodes in both lungs and the supracalvicular node doubled its size to 1.4 cm.

Pet diagnosis says that there is a chance that the lung lesions are nsclc secondary lung cancer and not prostate cancer.

I have to go through biopsy to determine which one is it.

I think it's a rare combination and prefer to belive that they are prostate mets.

Is there any members of the group with PC with mets to lungs? What's your treatment protocol or options?

I'll be glade to hear some thoughts and advice how to go from here.

Have to mention that I have tried few alternatives along the way

Like Rick Simpson oil, coc protocol ,various off label drugs and supplements.

Thx

[GP24]

I know a patient who treated his lung mets with Docetaxel. After the therapy a PSMA PET/CT did not find them any more.

[Niso in reply to GP24]

Thank you for your reply, for how long the mets were gone?

[GP24 in reply to Niso]

He was hormone sensitive with a PSA of 1000 ng/ml. They are gone for six years now.

[Niso in reply to GP24]

This great thank you

[MoonRocket]

Get a biopsy to confirm the lung lymph nodes. Sarcoidosis lights up on the PSMA scans.

In retrospect, triplet treatment would have been the way to go.

[Niso in reply to MoonRocket]

Thank you sir,I will do a biopsy soon.Wasn't aware to sarcoidosis lighting on psma.

What do u meant in triplet treatment? Adding texture?

Thx

[MoonRocket in reply to Niso]

ADT + 2nd line ADT + chemo = triplet

[Niso in reply to MoonRocket]

Thx

[gsun in reply to Niso]

Six years ago, triplet therapy was not SOC.

[Niso in reply to gsun]

Thx man, it doesn't really matters because we can't change the past ,we take our decisions according to our feelings,beliefs and knowledge at that moment,I never look back after taking so important decisions ,I did my best and I'm only human. Thank you

[Tall_Allen]

A good friend hed high risk PCa, and during his diagnostic workup, the radiologist noted a "ground glass" lesion on the periphery of a lung. An interventional radiologist biopsied it "in bore" and determined it was NSCLC. He received 3 high dose SBRT treatments and has been clear since then -4 years ago.

You have mCRPC. If now is not the time, when is?

[Niso in reply to Tall_Allen]

Thank you sir, I took uder consideration sbrt and going to meet my radiologist on Wednesday. What do you mean When you say this the time ? Chemo?

Thank you and appreciate your comment.

[Tall_Allen in reply to Niso]

"I have refused to chemo along the way and prefer to save it to further stages of my journey." Chemo works less well the longer you wait.

[Niso in reply to Tall_Allen]

Thank you for the clarification

[j-o-h-n]

I had lung cancer due to Melanoma metastasis and was treated with KEYTRUDA a immunotherapy medication, and it worked..... Check with Doc.....

Good Luck, Good Health and Good Humor.

j-o-h-n

[Boywonder56 in reply to j-o-h-n]

it also made you funnier ...

[Niso in reply to j-o-h-n]

Thank you John I'm familiar with immunotherapy, I'll be smarter after taking biopsy.Be well and keep laughing.

[Professorgary]

I had Mets in both lungs. Psa was 327 at the time in 2021. Psa went to 5664 a year later and started Lupron for 15 months and then added low dose abiraterone with food and 5mg prednisone. Last scan showed Mets were “interval resolution”, which I am told means they are resolved. Last Psa was 1.26 and dropping. No surgery, radiation or chemo. Praise the Lord!

[Niso in reply to Professorgary]

Good luck gary